Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 08029 | Date 06/04/2020 |
| Token No | SM/19-20/21013 11/04/2020 | Serial | 036 Last Visit: 31/07/2020 |
| Patient Name | Mr. KAMAL CHANDRA RUIDAS | Contact No | 7890749540 |
| Address | 107 AA TELIPARA BAGER BAGAN BAIDYABATI M | Age | 44 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||